Well, your irritation may be due to scabies, a.k.a. Sarcoptes scabiei, a parasitic mite transmitted by skin-to-skin contact with infected individuals. Scabies shows up as a raised, red rash with visible burrows in the skin and intense itching of infected areas. The itching is due to an allergic reaction to the movement of the mites under the skin and to the substances secreted by the mites.

How do you get scabies? Scabies is spread from person to person mainly by prolonged direct skin-to-skin contact, such as touching a person who has scabies. In rare cases, scabies can spread by contact with clothes, towels, bedding, and other personal items that were recently in contact with an infected person. The mites live on human blood and need the warmth

of the human body to survive. Away from the body, they die within 48 hours. The mites prefer to burrow between the digits of hands and feet, in the groin area, and behind the knee, as they are attracted to the human scent.

Contrary to popular belief, scabies is not a disease of poor personal hygiene. It can strike people of any age, race, or sex, regardless of personal cleanliness. However, it is more common among people living in crowded conditions and among those in close physical contact with others, such as children, mothers of infants, and persons in nursing homes.

Many cases of scabies can be diagnosed by a dermatologist without special tests. To confirm scabies a dermatologist can perform a painless evaluation that involves applying a drop of oil to the suspected lesion. The site is then scraped and transferred to a glass slide, which is examined under a microscope. A diagnosis is made by finding scabies mites or their eggs.

How is it treated? Scabies is most commonly treated with the topical cream, 5% permethrin, which is applied to the skin from the neck down at bedtime and washed off the next morning. Dermatologists recommend that the cream be applied to cool, dry skin over the entire body (including the palms of the hands, under finger nails, soles of the feet, and the groin) and left on for 8 to 14 hours. A second treatment one week later may be recommended. Antihistamines may be prescribed to relieve itching, which can last for weeks, even after the mite is gone. Usually, lesions heal within four weeks after the treatment. If a patient continues to have trouble, re-infestation may be a problem requiring further evaluation by the dermatologist. Getting rid of the mites is critical in the treatment of scabies. To prevent further spread or re-infection, everyone in the family or group, whether itching or not, should be treated at the same time to stop the spread of scabies. This includes close friends, day care or school classmates, or those in nursing homes. Bedding and clothing must be washed or dry cleaned.

Is scabies different from bed bugs? Yes. Bed bugs are in the insect family Cimicidae and include three species that attack people. Of these, the most important is Cimex lectularius which may also bite bats, birds, and rodents. Bed bugs are small wingless insects that seek out people and animals–generally at night while these hosts are asleep–and painlessly sip a few drops of blood. While feeding, they inject a tiny amount of their saliva into the skin. Repeated exposures to bed bug bites during a period of several weeks or more causes people to become sensitized to the saliva of these bugs; additional bites may then result in mild to intense allergic responses.

What does a bed bug bite look like? The skin lesion produced by the bite of a bed bug resembles those caused by many other kinds of blood-feeding insects, such as mosquitoes and fleas. Physicians often treat patients with antihistamines and corticosteroids to reduce allergic reactions and inflammation. Despite what you may have heard or read elsewhere, bed bugs are not known to transmit any infectious agents.

Where are they found and how do I get rid of them? Bed bugs are most abundant in rooms where people sleep, and they generally hide nearest the bed or other furniture used for sleeping. Because bed bugs readily hide in small crevices, they may accompany (as stowaways) luggage, furniture, clothing, pillows, boxes, and other such objects when these are moved between apartments, homes and hotels. Used furniture, particularly bed frames and mattresses, are most risky in terms of harboring bed bugs and their eggs.

Take home message: Because several different kinds of insects resemble bed bugs, specimens should be carefully compared with good reference images to confirm their identity. Only once you’ve confirmed that you do indeed have bed bugs should you implement a full cleansing of your infested areas. To guide you through this process, the Harvard School of Public Health has created a useful flow chart.

If you think it’s scabies, or obviously if you still aren’t sure, see your primary care doctor, or dermatologist, who will help diagnose your condition and prescribe the most appropriate treatment. Don’t forget to tell the people you live with or with whom you are in close contact so that they can take preventive measures against these bugs!